H&W Annual Report 2023-24 (3MB pdf)

Foreword by Lisa Ward, Director of People

I am very pleased to present our third NWAS Staff Health and Wellbeing Annual Report, covering the period 1 April 2023 – 31 March 2024.

Despite being a couple of years on from the COVID-19 pandemic, operational pressures continue to challenge our staff and service. Naturally, these pressures have an adverse impact on the health and wellbeing of colleagues. We know this through staff testimonials, anecdotes and responses from staff surveys.  For example, in the 2023 NHS Staff Survey, only around half of NWAS respondents believed that the organisation takes positive action on health and wellbeing, and many more felt burnt out by their work. While there were some positive results too, statistics such as these give us an important reminder to ensure our staff are cared for and supported.

In the last year, we have increased our delivery and output of wellbeing initiatives which I hope will make a positive difference to our colleagues. We have invested in developing a Workforce Wellbeing Team which soon will be launching a Wellbeing Hub as a one-stop-shop for managers and staff to access wellbeing information and services. This year we also held our first Wellbeing Festival which was a huge success, and we recruited a chaplain for staff wellbeing – a unique role in the whole of the ambulance sector!

This report celebrates all this work and more that we have undertaken this year, aiming to improve the health and wellbeing of our colleagues. I recognise there is much more we need to do to improve the employee experience, but I feel like we have made great progress in 2023/24, and look forward to building on it as we move forward in 2024/25.

I hope you find this report insightful and informative.

Lisa Ward, Director of People

The staff wellbeing context

Workforce wellbeing drivers

There are a number of national as well as sector-specific drivers which have continued to inspire the delivery of staff wellbeing projects and initiatives in 2023/24.

The NHS People Promise is a key national driver, and is at the heart of our People Strategy. It provides a framework through which we strive to provide the best for our staff.

The ‘We are safe and healthy’ element of the People Promise is about ensuring that we look after ourselves and each other. We recognise that wellbeing is our business and our priority – and for those who are unwell, they get the support they need.

We continue to a be a signatory to Mind’s Mental Health at Work Commitment which has been endorsed by The Royal Foundation.

The Commitment comprises of six standards, based on the Thriving at Work standards, and has been developed with the knowledge and expertise of mental health charities, leading employers and trade organisations.

Over the last year, we have continued to report progress on the AACE Employee Wellbeing and Suicide Prevention Self-Assessment Matrix, which sets out a number of tasks to be delivered on a range of areas relating to preventing staff suicides and improving the general health and wellbeing of colleagues.

We have also embedded the Mental Health Continuum resource developed by AACE to facilitate more effective wellbeing conversations between staff and managers.

National staff survey 2023

In 2023, we achieved our highest ever National Staff (NSS) Survey response rate of 48% which equated to over 3400 respondents.

The results showed an overall improvement in relation to the wellbeing-focused questions. However, significant numbers of respondents indicated that they felt burnt out because of work, and less than half believe the organisation takes positive action on wellbeing.

Additionally:

Around two-thirds said their immediate manager takes a positive interest in their health and wellbeing.

• Nearly half all respondents said that in the last 12 months they had been unwell due to work related stress.

• A third of staff said they had experienced musculoskeletal (MSK) problems as a result of work activities in the last 12 months.

• Around 30% of respondents said they had felt pressure from their manager to come to work when not feeling well enough.

Sickness absence

Sickness absence rates in the trust have varied across the year.

Contact centres remain the outliers in the organisation with the highest absence rates. However, both NHS 111 and Emergency Operations Centre (EOC) staff groups showed clear post-winter recovery, with EOC achieving its lowest rate of sickness absence in the last two years in February 24.

Paramedic Emergency Services (PES) had a reasonably static year and continued to lead the way in operational teams, with the exception of resilience. On the other hand, the graph shows that Patient Transport Service (PTS) sickness absence rate appeared to consistently increase throughout the year.

Sickness rates in 2024/25 are expected to see improvements, given a clear focus on sickness assurance paired with support from the new Occupational Health provider, Optima, who partnered with the trust in March 2024.

How we made an impact in 2023/24

Workforce Wellbeing Team

In 2023/24, the government released additional funds for ambulance services to support recovery of urgent and emergency care services. The purpose of the funding was to enable increases in frontline staff numbers and other resources. The funding could also be used for releasing capacity through better health and wellbeing for staff, leading to a reduction in sickness absence, productivity gains, and through better links between the ambulance service and community services.

To support the health and wellbeing of our staff, we utilised some of the funding to recruit a Workforce Wellbeing Team, comprising of a workforce wellbeing advisor and four workforce wellbeing officers (WWOs). The team was recruited over the summer period, with all members being in post by the beginning of October 2023.

Each of the workforce wellbeing officers have been designated a geographical area of responsibility in the trust footprint and collectively, they play a key part in helping to bring our staff health and wellbeing offer to life, supporting a positive employee experience and thriving organisational culture.

Over the last year, the WWOs have;

• Supported the delivery our first NWAS Wellbeing Festival (read more about this later in the report)
• Regularly and proactively engaged with staff by being a visible presence on stations, in contact centres and corporate offices.
• Provided information, advice and guidance to staff and managers on the range of wellbeing services available.

The Wellbeing Team will be establishing a new Wellbeing Hub in 2024/25, as a one-stop-shop for all wellbeing-related information and services in NWAS.

Chaplain for staff wellbeing

The Chaplain for Staff Wellbeing Reverend Karen Jobson started in post in September 2023 to work across NWAS, providing confidential listening and support in times of change, challenge, and distress.

Since joining the trust, Karen has proactively engaged with colleagues across the organisation – with a view to ensuring that when stressful situations arise, they are confident in contacting her as an avenue of support. In her first few months in NWAS, Karen engaged with more than 700 staff members at over 50 sites including contact centres, ambulance stations, accident and emergency hospital departments, and at staff network events. She also undertook a number of observation shifts with crews and has been working collaboratively with the Freedom to Speak Up guardian to inform staff about the services available to them, and listen to their concerns.

Karen has provided pastoral support at two cold debriefs following a major incident and supported colleagues of three members of staff who have died in service. She has facilitated 1:1 conversations, small and large group discussions, as well as leading a Time of Remembrance for Remembrance Day and provided space and support to mark the National Day of Reflection for COVID-19. lain for Staff Wellbeing

We know that work and personal circumstances outside of work have an impact on wellbeing. In recognition of this, Karen has offered bookable pastoral sessions under the banner of ’Chat to the Chaplain’ at five of the larger trust sites, and by phone or video call for all staff. Over 80 sessions have been delivered, and emerging themes have included dealing with bereavement, managing relationships, life stress and the cost-of-living crisis. A small number of colleagues have sought support for their spiritual wellbeing.

In 2024/25, we are aiming to further enhance the chaplaincy for staff wellbeing service with the introduction of a number of volunteer chaplains from a range of faith backgrounds and different parts of the North West. Karen will also be developing plans around formalising the support that can be offered when a colleague dies in service and in establishing bereavement support groups to provide staff with peer support, psychosocial education, and skills in managing grief.

NWAS action cards for significant illness, injury, suicide attempt, suicide or death in service.

In the last year, we made some important changes and improvements to our action cards which are used in the most serious staff welfare incidents.

The action cards detail activities which should be undertaken by NWAS leadership teams and other key internal stakeholders in the event of an incident. Such events could include significant illness or injury, suicide attempt or suicide, or for a death in service.

Each action card is specific to a designated role which has been deemed essential in ensuring our that our values – working together, being at our best and making a difference – are met. They have been designed to assist our leaders in a way which optimises care and compassion for our colleague and their nominated next of kin arrangements.

The improvements to the action cards were based on lessons learned from the using the cards during the COVID-19 period, as well as learning from recent staff suicide events.

All heads of departments and on call teams responsible for leading people in the trust are expected to be familiar with the action cards, and ensure they understand the application of their individual and collective role responsibilities.

A briefing was circulated to managers in March 2024, informing them of the cards and signposting to the Green Room for more information.

Wellbeing communications

Over the last year, our Communications Team has continued to support the promotion of key health and wellbeing messages and information. A regular feature of the Communications Team output has been the Better Health, Better You newsletter, published monthly and circulated to all staff via email.

This newsletter encompasses the spirit of ‘by staff, for staff’. Each edition has focused on a wellbeing-themed topic. The main feature in newsletters has been a real-life experience shared by a staff member, in the hope of raising awareness and encouraging their colleagues to reach out for support.

Topics covered during 2023/24 include cancer support, financial wellbeing, Disability History Month, menopause, suicide prevention awareness, addiction support, PTSD, men’s health, eating disorders, stress awareness and endometriosis awareness.

Topics often link to national wellbeing campaigns or awareness days. The newsletter provides an alternative, engaging opportunity to communicate with staff, raising awareness on a range of wellbeing topics and associated signposting available.

NWAS Wellbeing Festival

In November 2023 we held our first NWAS Wellbeing Festival at Estuary Point, which saw around 150 members of staff attend.

The event was open to all staff who worked at Estuary Point or at sites within the local area, and provided a range of bitesize educational and interactive health and wellbeing experiences, plus the opportunity to get a health check done on the day. 

The NWAS Wellbeing Team worked in collaboration with the NWAS Public Health Team to deliver the event which marked the first in a series of wellbeing festivals, with a number of pop-up events planned across the North West over 2024 into 2025.

Festival highlights included a special guest visit from two newfoundland dogs courtesy of Pete Lewin Newfoundland’s. The larger-than-life duo made themselves at home and certainly seemed to enjoy all the attention. Competition was afoot on the smoothie bikes, with staff enjoying the fruits of their labour in the form of a smoothie. Networking a plenty took place in the marketplace hall, with key stakeholders engaging, including a freebie or two. Various educational sessions were on offer, including taster sessions such as pickle ball and breathing exercises. 

Wellbeing resources

We know that our wellbeing can be affected by all kinds of factors, which is why the NHS People Plan encourages all NHS organisations to create cultures where our staff have regular wellbeing conversations with their line manager.

So, in 2023/24 we worked on developing a new wellbeing conversations template for managers to support their team members. This resource is backed up with a refreshed guidance document and will be launched in spring 2024.

Training around effective wellbeing conversations will be delivered in partnership between the Learning and Development and Workforce Wellbeing Teams.

Wellbeing and carers passports

Linked to wellbeing conversations, are wellbeing passports, which have been used in NWAS since 2021. Work took place in 2023 to review and refresh the passport template and guidance document, with an aim to streamline and simplify the documents.

Through this process, we identified a need to introduce a carers passport. Both passports provide a structured approach to opening up conversations to assess support and services required for individuals.

As part of the refresh, engagement was undertaken with stakeholders from across the organisation, including the staff networks. Future plans include development of a digital passport.  

Nurturing a culture of positive wellbeing

Mental Health Continuum Delivery Group

This group was established in 2022 to facilitate the trust-wide implementation of the AACE Mental Health Continuum tool, as well as other national and ambulance sector-specific initiatives, ensuring an organisational comprehensive approach to mental health and wellbeing.

In July 2023, the group held a workshop with representation from all service lines in the trust, which aimed to identify projects to support key staff wellbeing priorities. The group has agreed to focus on three key areas, which each have a workstream established:

• Improving access to wellbeing information
• Mental health and suicide prevention
• Managers, leaders and culture.

Just ‘B’ – proactive wellbeing calls

2023/24 saw the final cohorts of staff being offered pro-active, confidential, and emotional wellbeing support telephone calls delivered through the ‘JustB’ programme and funded by the Royal Foundation. This programme was first launched at the end of 2021 with colleagues in operational service lines from across the trust having the opportunity to participate.

The service aimed to support colleagues who may benefit from emotional and mental health support, but who may not readily seek out that support.

In total, nearly 900 staff members took up the opportunity to have a wellbeing check in call, where they had an opportunity to discuss how they felt at home and in work, and whether they required any support to improve their wellbeing

Massage chairs in contact centres

Massage chairs to boost staff wellbeing were introduced in our contact centres across the region in November 2023.

Funded by an AACE grant, eight Alpha Techno 599I massage chairs were installed across all our contact centres to help support staff wellbeing. Sites included Broughton, Estuary Point, Parkway, Middlebrook, Oldham and Salkeld.

Feedback relating to the provision of these massage chairs has been highly positive. A staff member at Estuary Point said, “What an outstanding purchase the massage chairs are proving to be. Staff have thoroughly enjoyed testing out the variety of functions and they are all fabulous. We’re feeling well and truly spoilt and I think they will prove to be beneficial to all. Thank you!”

Menopause support

Over the last year, we have continued to try to foster an environment in which staff can openly and comfortably engage in discussions about menopause. Additionally, we have encouraged colleagues to ask for support and adjustments at work, without fear or embarrassment, so that they can thrive in a safe working environment, and it can help support them to remain in the workplace wherever possible.

• Recruited a further 17 menopause champions to take our total to 37
• Delivered menopause awareness training to more than 50 managers
• Held quarterly meetings with menopause champions
• Designed and delivered a new training package for menopause champions
• Supported delivery of five menopause café sessions
• Continued to promote fortnightly menopause lunch and learn sessions with Henpicked
• Created a menopause champions Teams channel to facilitate greater networking 

Trauma Risk Management (TRiM)

TRiM is a peer delivered risk assessment tool. It is used to determine by what degree, if any, a member of staff has been affected by an incident, provide a degree of peer support and advice to promote recovery and, if necessary, refer the individual for further professional help through the Occupational Health system.

At NWAS, we have over 200 TRiM practitioners who are active across all contact centres and operational areas. The latest course (pictured) increased the number of TRiM practitioners across South Lancashire as well as the Community Resuscitation Team who provide support to our Community First Responders.

In 2023 the TRiM practitioners were able to offer 1,329 staff members a TRiM assessment following a potentially difficult incident. They completed 100 TRiM assessments and successfully referred and supported 38 members of staff to access further support in the form of professional counselling services.

Therapy dogs

In 2023-24, we continued our partnership with ‘Therapy Dogs’ and ‘Pets as Therapy’. Pets (dogs in particular) are proven to boost productivity and reduce stress, as well as enhance the workplace atmosphere. Feedback from staff has always been positive throughout the year with the dogs and their handlers always being warmly welcomed by all.

Staff continue to have access to booking visits through both Pets as Therapy and Therapy Dogs by contacting their health and wellbeing leads, and we hope that these much-loved animals will continue to bring joy throughout 2024-25.

At our first Wellbeing Festival, Mike, a Pets as Therapy volunteer, accompanied by the lovely greyhound Queenie, kindly gave up their time to say hello to some NWAS staff, making their way around the 111, PTS, EOC, and IT departments. Mike shared heartwarming stories about the rescue of Queenie and their journey in life together so far, which was greatly received by both staff and managers.

In December 2023, Claire Hunter, Workforce Wellbeing Officer for Cheshire and Merseyside, targeted local PES stations with Christmas-themed visits, asking Therapy Dogs and Pets as Therapy volunteers to accompany her where possible.

What became known as the ‘festive friends’ initiative really took off and gathered momentum in the lead up to Christmas, providing our frontline staff with some much-needed relief from the winter pressures in the form of furry four-legged TLC!   

Wellbeing initiatives

During 2023-24 we have delivered a range of initiatives to support and engage staff in their wellbeing. Working with a range of internal and external providers to deliver a variety of holistic sessions with a focus on a people centered approach.

• We worked with external partners to deliver webinars on a range of different topics including financial wellbeing and mental health.   
• Engagement has taken place with teams across different service lines to highlight the trust wellbeing offer. The Workforce Wellbeing Team has attended inductions, team development days and team meetings. 
• Manchester Stress Institute has led several wellbeing interventions over the past twelve months, including 1-1 personal resilience sessions within EOC, bespoke wellbeing taster sessions such as emotional freedom tapping, and concluding their work supporting the delivery of a number of short courses, such as British Sign Language. 
• We have grown the cohort of health and wellbeing (H&W) leads with the inclusion of representation from corporate teams – this means we now have H&W leads for all parts of the organisation. The leads provide a vital function in promoting key wellbeing messages, while also feeding back experiences and ideas from staff to help improve the employee experience.

NWAS Charity and staff wellbeing in 2023/24

The North West Ambulance Charity provides support and enhancements to NWAS by funding life-saving equipment and other projects benefitting the health, wellbeing and safety of patients, staff, and our communities.

The charity is a legally separate entity from our NHS trust and is completely reliant upon generous donations and fundraising from the public, businesses, grant funders along with support from our colleagues and volunteers.

We have continued to work very closely with the NWAS Charity on projects supporting the wellbeing of our staff and volunteers, which is also a key objective for the charity. Indeed, many of the Workforce Wellbeing Team’s initiatives are enabled thanks to funding from the NWAS Charity.

Hardship fund

In response to the cost of the living crisis, the NWAS Charity launched a hardship fund for staff in August 2022, which remained open until March 2024. Over the 20-month period of the scheme, a total of 734 applications for support had been received from staff across the trust. Of these, 630 were approved for a grant of up to £250 (maximum amount that could be applied for). The total value of grants paid out was around £150,000.

During April 2023, a significant piece of work was undertaken with PTS management teams at the request of the director of operations, due to concerns that PTS staff were proportionately underrepresented. This resulted in a large spike in applications over the following month with the record being 38 during one single week in May 2023.

Across the duration of the fund, over the 330 applications were received from staff in contact centres, 260 from PTS staff more than 90 from PES. Around 50 applications were from staff in corporate teams.

While the fund has now closed, the charity is looking at other ways to continue funding health and wellbeing support for our staff and volunteers.

Wellbeing projects funded by NWAS Charity

Enhancing indoor spaces

The charity supported with an enhancement grant for colleagues in NHS 111 at our Middlebrook site, to convert a previously underutilised space to create an area suitable for relaxation, and in which to hold debriefing sessions following particularly distressing calls or incidents.

The wellbeing spaces were developed with the input of 111 champions, with extremely positive feedback received from colleagues who have been using the facilities.

Gym equipment

In 2023, the NWAS Charity funded gym equipment at the new Blackpool Ambulance Station Hub to support the health and wellbeing of colleagues.

Enhancing outside spaces

Charity grants have also supported with additional indoor and outdoor furniture, and other much-needed enhancements to our ambulance stations and other NWAS sites, providing better relaxation facilities while in work.

The charity funded new picnic table (made of recycled plastics) for outside Penrith Ambulance Station.

What next in 2024/25?  

The charity will be delivering a programme of further site enhancements across the region, aimed at improving staff wellbeing. Planning is also underway to fund a series of events (both internal and external) to give our colleagues the opportunity to sample activities and therapies which can benefit their wellbeing.

The NWAS Charity will continue to support the provision of volunteer-led welfare vehicles, visiting hospital emergency departments to provide refreshments and a friendly face for crews experiencing handover delays, overseen by the Workforce Wellbeing Team.

National engagement

National Wellbeing Ambulance Forum

We have continued to be a member of and contribute to the National Ambulance Wellbeing Forum (NAWF), which brings together wellbeing leads from all the ambulance services in England, Wales, Scotland and Northern Ireland. 

The purpose of the forum is to:

• Deliver and embed at a local trust level the AACE agreed priorities that improve the health and wellbeing of staff and seek to reduce the incidence of suicide in the sector.
• Act as a ‘reference group’ providing expert advice and guidance on matters of staff health and wellbeing. 
• Carry out specific projects associated with the delivery of staff health and wellbeing activity across ambulance services. 
• Support continuous improvement in staff health and wellbeing by utilising the experience and expertise within the group.
• Provide an informed perspective on current and relevant reports and reforms which have implications for the ambulance services where this relates to staff health and wellbeing. 
• Horizon scan and provide information on emerging trends, legislation and guidance.
• Provide a supportive network for wellbeing leads and opportunities for networking.
• Identify in line with national guidance appropriate measurement of health and wellbeing.
• Influence the development of national policy supporting health and wellbeing.

The Ambulance Staff Charity (TASC)

TASC continue to provide a range of services to support the mental health, physical rehabilitation, and financial wellbeing of the UK’s ambulance staff, their family members, students, and ambulance service volunteers.

We have continued to promote the TASC crisis phone line which is completely independent and confidential, providing immediate and ongoing suicide and mental health care for UK ambulance staff. They can be contacted on 0300 373 0898 24/7,365.

Health and wellbeing in numbers

Services accessed in 2023/24

Occupational Health

• 3935 physiotherapy sessions
• 1888 counselling sessions
• 701 specialist counselling sessions (CBT/EMDR/IFS)

Employee Assistance Programme (EAP)

• 1221 visits to EAP online support portal
• 116 phone calls to the EAP for support

Trauma Risk Management (TRiM0

• 1329 staff members offered TRiM support
• 100 staff members accessed TRiM assessment
• 38 staff referred to counselling from TRiM

Salary Finance

• 90 loans funded
• 1197 visits to the SF financial wellbeing hub
• £3,245 average value of loans

Salary Sacrifice schemes

• 1066 home electronics orders placed
• 48 cycle to work orders placed

Priorities for 2024/25

To ensure that we continue to meet the health and wellbeing needs of our workforce, we will be focusing on delivering the following key priorities in 2024/25.

• Launch the Wellbeing Hub in May 2024 as a one-stop-shop for health and wellbeing in NWAS, providing a single point of contact for staff and managers to access information about the range of services available which can support their wellbeing.
• Grow the range of wellbeing training resources to further enhance the current Learning and Development offer.
• Wellbeing content across the range of internal communications platforms will be reviewed and refreshed with a focus on making content easy to access.
• Deliver programmes of work improving staff wellbeing emerging from the Mental Health Continuum Delivery Group workstreams.
• Facilitate the growth of a range of support groups for staff which will offer the opportunity to connect and network with colleagues who have similar interests or have experienced certain live events. They will be a safe space for colleagues to interact, share information and experiences, signpost to services and support each other

Produced by the Workforce Wellbeing Team

Contact information for The Wellbeing Hub:

• Email: [email protected]
• Phone: 0151 642 2440